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Updated: Dec 9, 2025
A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
Blood Transfusion Frequency and Indications in Yemeni Children with Sickle Cell Disease
Abdul-Wahab M Al-Saqladi1,2, Dikra M Maddi1,2, Aida H Al-Sadeeq1,2
1Pediatric Department, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen.
Insights
Blood transfusions are crucial for hospitalized children with sickle cell disease (SCD), primarily for managing anemic and pain crises. A conservative transfusion approach is suitable in low-resource settings like Yemen.
Area of Science:
- Hematology
- Pediatrics
- Public Health
Background:
- Sickle cell disease (SCD) management relies heavily on blood transfusions, which carry risks of complications.
- Understanding transfusion practices in low-resource settings is vital for optimizing patient care.
- This study focuses on transfusion patterns in hospitalized children with SCD in Yemen.
Purpose of the Study:
- To describe red blood cell (RBC) transfusion patterns in hospitalized children with SCD.
- To identify the primary indications for blood transfusions in this population.
- To evaluate transfusion practices in a low-resource healthcare environment.
Main Methods:
- Retrospective, descriptive study design.
- Inclusion of all children (≤16 years) with SCD admitted to Al-Sadaqa Teaching Hospital, Aden, Yemen.
- Data collection over a one-year period.
Main Results:
- 169 out of 217 (77.9%) hospitalized SCD children received 275 RBC transfusion episodes.
- Lower hemoglobin (Hb) levels (5.5 g/dL) were observed in transfused children compared to non-transfused (7.7 g/dL).
- Anemic crises (41.1%), vaso-occlusive crises (VOC) (13.8%), and acute chest syndrome (ACS) (8.7%) were leading transfusion indications.
Conclusions:
- Intermittent blood transfusion is a common management strategy for acute SCD complications in children.
- Anemic crises, severe pain crises, ACS, and stroke are key indications for transfusion.
- A conservative transfusion policy is deemed appropriate for resource-limited settings like Yemen.
Background:
Blood transfusion is an essential component in the care of patients with sickle cell disease (SCD), but it might be associated with serious acute and delayed complications. This study was aimed to describe red cell transfusion patterns and indications among hospitalized SCD children in a low-resource setting. Patients and Methods. A retrospective, descriptive study of all children (≤16 years) with SCD who received blood transfusion therapy during their hospital admissions in the pediatric department at Al-Sadaqa Teaching Hospital in Aden, Yemen, for a period of one year.
Results:
Out of 217 hospitalized children with SCD, 169 (77.9%) were transfused and received 275 RBC transfusion episodes. The mean age of transfused children was 6.9 ± 4.6 years and 103 (60.9%) were males, with a male/female ratio of 1.6 : 1 (p=0.004). Hemoglobin (Hb) levels were significantly lower in the transfused than in the nontransfused (Hb 5.5 ± 1.5 vs. 7.7 ± 1.5 g/dL, p=0.03). Pretransfusion Hb levels were ˂7.0 g/dL in 86.2% and ˂5.0 g/dL in 39.3% of patients. Single transfusion was given to 122 (72.2%) and 5 or more transfusions in 9 (4.15%) of patients on different occasions. Simple (top-up) transfusion was used in all transfusion events. Commonest indications for transfusion were anemic crises (41.1%), vasoocclusive crises (VOC) (13.8%), VOC with anemic event (11.3%), acute chest syndrome (8.7%), and stroke (7.3%).
Conclusion:
Intermittent blood transfusion remains a common practice for the management of children with acute SCD complications. Main indications were acute anemic crises, severe pain crises, ACS, and stroke. In limited resource settings, such as Yemen, conservative transfusion policy appears to be appropriate.
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